1. Identity Details (Please refer instruction A at the end) Name* (same as ID proof) Maiden Name (If any*) Mother Name* Residential Status* Resident Individual Non Resident Indian Foreign National Person of Indian Origin Occupation Type* S-Service Private Sector Public Sector Government Sector O-Others Professional Self Employed Retired Housewife Student B-Business X-Not Categorised Middle Name Last Name First Name Prefix PAN Please enclose a duly attested copy of your PAN Card 5. Applicant Declaration Date: Place : • I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. I hereby declare that I am not making this application for the purpose of contravention of any Act, Rules, Regulations or any statute of legislation or any notifications/directions issued by any governmental or statutory authority from time to time. • I hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address. Signature / Thumb Impression of Applicant [Signature / Thumb Impression] D D M M Y Y Y Y Related Person Type* Name* (If KYC number and name are provided, below details of section 6 are optional) Guardian of Minor Assignee Prefix First Name Authorized Representative Middle Name Last Name 3. Details of Related Person (Optional) (please refer instruction G at the end) (in case of additional related persons, nnexure B1’) Related Person Deletion of Related Person KYC Number of Related Person (if available*) A- Passport Number Passport Expiry Date B- Voter ID Card C- PAN Card D- Driving Licence Driving Licence Expiry Date E- Aadhaar Card F- NREGA Job Card Z- Others (any document notified by the central government) Identification Number (Certified copy of any one of the following Proof of Identity[PoI] needs to be submitted) Y Y Y Y Proof of Identity [PoI] of Related Person* (Please see instruction (H) at the end) M M D D Y Y Y Y M M D D 4. Remarks (If any) 2. FATCA/CRS Information (Tick if Applicable) Residence for Tax Purposes in Jurisdiction(s) Outside India (Please refer instruction B at the end) Additional Details Required* (Mandatory only if above option is ticked) Country of Jurisdiction of Residence* Country Code of Jurisdiction of Residence Tax Identification Number or equivalent (If issued by jurisdiction)* Place / City of Birth* Address Country of Birth* Country Code as per ISO 3166 as per ISO 3166 Line 1* Line 2 Line 3 City / Town / Village* District* Zip / Post Code* State/UT* Country* Country Code as per ISO 3166 State/UT Code as per Indian Motor Vehicle Act, 1988 Know Your Client (KYC) Application Form For Individuals Only (Please fill the form in English and in BLOCK Letters) Fields marked with * are mandatory fields (To be additionally filled by customers using old KYC form) Supplementary CKYC Form KYC Type: Normal (PAN is mandatory) PAN Exempt Investors Page 1